‘Your efforts can improve outcomes for people affected by cancer’

I really enjoy working with people who are passionate about making a difference. Even if you encounter challenges in your work, or have a difficult day, there's a motivation to keep going, because ultimately your efforts can improve outcomes for people affected by cancer.

Working with people from different disciplinary or professional backgrounds is also something I value. As Head of Social and Behavioural Research at Cancer Research UK – a role I started in November 2022 – my remit includes developing and leading a new team, shaping a dynamic programme of work related to behavioural science, implementation research and service evaluation, embedding rigorous behavioural science and social research methods across the Policy, Information and Communications (PIC) directorate, and influencing for the adoption of evidence-based best practice innovations into policy and practice. As a member of the Evidence and Implementation Leadership Team and CRUK's Extended Leadership Community, I work with colleagues to develop and take forward strategic initiatives, as well as working with external partners and stakeholders to drive improvements in cancer outcomes. Across the team we bring a range of perspectives, which keeps thinking fresh. I'm always learning from people I work with, and I'm inspired by the skill and commitment they bring to their work.

There are lots of challenges involved in taking forward innovation projects. For example, frontline clinicians who are well placed to identify what needs to change in order to improve cancer outcomes do not necessarily have easy access to resources needed to design and conduct a formal evaluation. So, we take an 'active commissioner' role, helping to match NHS partners with relevant academic experts and health system partners, to take the project all the way through from design to implementation, evaluation and scale-up. We stay involved throughout the project to help problem-solve challenges encountered and draw on our resources and relationships to help the projects achieve real-world impact.

Saving lives through research, influence, and information

Cancer Research UK is the world's leading cancer charity dedicated to saving lives through research, influence, and information. Social and behavioural research has an important role to play across these areas. For example, research is helping to identify approaches to tackle issues including engagement in genetic testing, uptake and maintenance of preventive health behaviours, avoidance/cessation of health risk behaviours, understanding health information, reducing reliance on misinformation, medical decision making and communication, risk perception, symptom recognition, help-seeking, screening attendance, treatment adherence and acceptance of palliative care (Klein et al., 2022; Quinn-Scoggins et al., 2021). Insights may be applied to both health policy and the design, delivery and evaluation of healthcare interventions and services (Health Foundation, 2017; McManus et al., 2018; World Health Organization, 2022).

Research focusing on social and environmental determinants of health-related behaviours and health outcomes (and their interrelationships) is important for understanding variability at individual, community, and population levels, as well as factors contributing to health inequalities (Marteau et al., 2021). Social and behavioural research insights can also enhance the effectiveness and efficiency of health initiatives, by designing approaches which are appropriately tailored to the target behaviour, population, and context, which helps to protect against designing interventions and services in ways that widen inequalities or directing resources toward activities with limited potential for impact (Whitaker, 2020).

What I bring to this is around 25 years' experience in the health psychology and allied fields ((e.g. health services research, evaluation and implementation science), including research, practice, leadership and advisory roles across academia, the charity sector, NHS, and industry. Alongside my role at CRUK, I hold an Honorary Chair (Professor of Health Psychology) in the University of Kent's Centre for Health Services Studies and I'm a Chartered Psychologist and Health and Care Professions Council Registered Health Psychologist. Previous roles have included Research Adviser and Academic Site Lead for the NIHR Research Design Service Southeast, Health Psychology Lead for an NHS Diabetes Psychology Service and Behavioural Science Specialist for a global industry leader in healthcare data analytics. 

Key themes

The Social and Behavioural Research team brings together established and novel programmes of work across two strategic themes.

The Cancer Prevention and Services theme includes:

- Policy-focused Prevention Research, which generates evidence to inform and enhance approaches to address preventable causes of cancer, such as tobacco, alcohol and obesity;

- Health Services Research to optimise the wider pathway and research environment; and

- our Test Evidence Transition programme, which develops and evaluates new models of cancer service delivery, providing funding and support to NHS teams.

The Behavioural Evidence and Interventions theme includes:

- Health Behaviour Research which collects and analyses self-reported data from key audiences to inform strategic planning and support external influencing;

- Intervention Design, applying behavioural science models, frameworks, and methods to design evidence and theory-based behaviour change interventions; and

- Testing and Evaluation, applying expertise in evaluation design, quantitative and qualitative methods, and commissioning to conduct concept and creative testing and evaluate the impact of PIC initiatives.

The team works across these strategic themes, which allows a joined-up approach, harnessing insights from a range of disciplines and methodologies. This helps to build a detailed and nuanced perspective on the multitude of factors shaping cancer-relevant outcomes, as well as identifying evidence-based approaches to address barriers across the pathway, covering prevention, diagnosis, and treatment of cancer.

We also work closely with other teams across PIC, including Strategic Evidence, Cancer Intelligence, Health Systems Engagement and Policy Development, to ensure that the research we conduct and commission addresses key evidence gaps. It's about where we can have the biggest impact for people affected by cancer, translating evidence into actionable insights and generating 'the right kind of evidence at the right time' to influence policy and practice.

One example is our regular survey programme, which monitors public and health professional awareness, attitudes, and behaviours in relation to cancer prevention, early diagnosis, and screening, as well as providing insight on current topic areas. Findings inform our planning, policy development and wider influencing activity. Survey findings are also shared with external stakeholders responsible for encouraging prompt help-seeking at national and local levels. We have worked with a range of academic partners to develop these measures and are planning to undertake validation studies, particularly of our Cancer Awareness Measure (CAM). (https://www.cancerresearchuk.org/health-professional/awareness-and-prevention/the-cancer-awareness-measures-cam). The CAM data we have collected since 2008, are available for researchers to access and use via the UK Data Archive (https://www.data-archive.ac.uk/).

A second example is our recently launched Test Evidence Transition programme, which aims to evidence pathway interventions that will reduce unacceptable variation in cancer outcomes. The programme provides funding and support to frontline NHS teams and academic partners working together to achieve three objectives: Test innovations to support optimal cancer pathways that transform clinical practice; Evidence the process, outcome, and impact of implementation; and work with strategic partners to ensure the Transition of identified best practice into effective and equitable adoption across the NHS. The first phase of this new programme started in April 2023, providing funding and support to three frontline NHS teams in Scotland and Wales exploring pathway innovations in diagnosis for breast and prostate cancer.

Future plans

The team I lead was previously two teams, with different structures, processes, and remits. My role has involved creating new structures and processes that work for the team as a whole, as well as other teams we work with, facilitating shared learning and collaboration, and raising awareness of the new team with our partners and stakeholders. There's more I would like to do in relation to this, including engagement and outreach activities with academic, professional and public audiences.

Enhancing the impact of our research, evaluation, and innovation activities is a major goal. We'll be sharing insights and learnings across relevant programmes and workstreams. Opportunities to improve cancer outcomes can come from mapping and targeting key social, environmental, and behavioural determinants, and co-creating a suite of validated tools and resources. These will support NHS partners to gather and use evidence and insights to inform service design, delivery, and innovation at local and national levels. We need to launch the next phase of our TET programme, as well as wider engagement and dissemination activities to raise awareness of the role of social and behavioural research in cancer prevention, diagnosis, and treatment.

Then there's always fundraising, which feeds into a great community around the 'day job' too. I took part in CRUK's 31 Days of Yoga Challenge in January, and in February I was in London for the CRUK 10K. There was a great atmosphere, with many streets in central London closed to traffic to allow runners, walkers, and supporters to take over. There are lots of other ways to raise funds too. It is difficult to resist the regular bake sale offerings when I'm in the office… eating cake can be a good motivation to keep up the activity challenges! 

References

Klein, W., O'Connell, M., Bloch, M., et al. (2022). Behavioral Research in Cancer Prevention and Control: Emerging Challenges and Opportunities. Journal of the National Cancer Institute, 7(114), 179-186.

Marteau, T., Rutter, H. & Marmot, M. (2021). Changing behaviour: an essential component of tackling health inequalities. BMJ, 372, n332.

McManus, J., Constable, M., Bunten, A. & Chadborn, T. (2018). Improving people's health: Applying behavioural and social sciences to improve population health and wellbeing in England. London: Public Health England.

Quinn-Scoggins, H., Cannings-John, R., Moriarty, Y., et al. (2021). Cancer symptom experience and help-seeking behaviour during the COVID-19 pandemic in the UK: a cross-sectional population survey. BMJ Open,11, e053095.

Whitaker, K., (2020). Earlier diagnosis: the importance of cancer symptoms. The Lancet Oncology, 21(1), 6-8.

World Health Organization (2022). Behavioural sciences for better health initiative (A75/25)